Prosthesis or osteosynthesis for the treatment of a pathological hip fracture? A nationwide registry-based cohort study

Tsagozis, Panagiotis; Ehne, Jessica; Wedin, Rikard; Hedström, Margareta

doi:10.1016/j.jbo.2021.100376

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…Pathologic fractures especially those exposed to radiation rarely, if ever, heal 53 . A nationwide Swedish study of 980 patients found an endoprosthetic to be superior in function and pain relief compared with osteosynthesis for pathologic fractures of the proximal femur 54 . In patients with more disseminated disease, surgeons should take care to augment their construct with long-stemmed options versus a long lateral plate to bridge the diseased bone.…”

Section: Treatmentmentioning

confidence: 99%

Team Approach: Management of Pathologic Fractures

et al. 2023

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Optimal care for pathologic fractures centers on the use of a multidisciplinary team; thus, whenever there is a concern for pathologic fracture and proper workup is unable to be performed, prompt referral to a center equipped to manage these injuries should occur.» Fixation strategies for pathologic fractures must take into account patient characteristics, cancer subtypes, and overall goals of treatment.

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Section: Treatmentmentioning

confidence: 99%

Team Approach: Management of Pathologic Fractures

et al. 2023

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“…One of the methods used in the treatment of hip fractures is endoprosthesis. [5][6][7][8] In this method, the operation involves fitting a fracture prosthesis. Endoprosthesis, which provides more advantages compared to those of traditional hip fracture methods, may be applied as in part or its entirety.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality in patients with endoprosthesis after hip fracture

Yilmaz,

Kurt,

Dülgeroğlu

2024

Medicine

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In this research, we aimed to investigate the predictive value of the systemic immune inflammation index and prognostic nutritional index on mortality among patients with an endoprosthesis after a hip fracture. In this retrospective, cross-sectional study, a total of 915 patient files applied to our hospital between 2020 and 2023 with an endoprosthesis after a hip fracture were subjected to the study. The patients were divided into 2 groups: alive (n = 396; 43.3%) and deceased (n = 519; 56.7%). The eosinophil-to-lymphocyte ratio, hemoglobin-to-red cell distribution width ratio (HRR), mean platelet volume-to-platelet ratio (MPVPR), neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, monocyte-to-eosinophil ratio (MER), neutrophile-to-monocyte ratio, systemic inflammation index (SII), and prognostic nutritional index (PNI) parameters of the patients were evaluated. The mortality rate was higher among male patients, with a statistically significant difference (P < .05). The follow-up duration, albumin, HGB, eosinophil, lymphocyte, eosinophil %, eosinophil-to-lymphocyte ratio, HRR, and PNI means were significantly higher in the living group (P < .05). Age, MPV, MPVPR, neutrophil-to-lymphocyte ratio, monocyte/lymphocyte ratio, platelet-to-lymphocyte ratio, MPV-to-lymphocyte ratio, MER, and systemic inflammation index were significantly higher in the deceased group (P < .05). The predictive value of gender (B = −0.362; P < .01), age (B = 0.036; P < .01), HRR (B = −1.100; P < .01), MPVPR (B = 8.209; P < .01), MER (B = 0.006; P < .01), and PNI (B = −0.078; P < .01) were statistically significant at the multivariate level. The time of death was significantly predicted by gender (B = 0.10; P < .05), age (B = −0.02; P < 0 = 1), HRR (B = 0.61; P < .01), MPVPR (r = −4.16; P < .01), MER (B = −0.01; P < .05), and PNI (B = 0.03; P < .01). The predictive value of PNI for the 30-day mortality rate was statistically significant (AUC: 0.643; P < .01). For a PNI cutoff value of 34.475, sensitivity was 69.7%, and specificity was 51.1%. The PNI has predictive value both in estimating overall mortality and in predicting the 30-day mortality rates among patients undergoing endoprosthesis after a hip fracture.

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“…Among these surgical procedures, the hip joint becomes a challenging point for treatment due to its unique anatomical position [12], especially involving lesions in the hip socket and pelvic stress conduction area. These joints bear enormous stress when standing under load, making them the most common site for pathological fractures [13]. Periarticular metastatic damage often causes gradual displacement of the femoral head towards the top and inner side of the acetabulum, sometimes resulting in acute acetabular fractures or collapse; despite effective radiotherapy, this site may experience local bone dissolution and necrosis, leading to pathological fractures or joint collapse [14].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatments of metastatic bone disease of the hip joint：A scoping review protocol

Mao,

Liu,

Feng

et al. 2023

Preprint

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Background Metastatic disease of the hip causes severe pain and is a serious threat to the patient's motor function. Surgery is required, but the actual efficacy is unclear and there are many concerns for both patients and doctors. The purpose of this protocol is going to conduct a scoping review for helping decisions of intended audience. Methods This scoping review will be conducted according to the framework proposed by Arksey and O'Malley and reported in accordance with PRISMA-ScR criteria. To answer our research questions, we will search Chinese and English databases using appropriate search terms, comb through clinical studies on surgical procedures for metastatic bone disease of the hip and incorporate visual charts and graphs to provide a comprehensive analysis and evaluation of the literature according to the criteria for basic characteristics, interventions, and outcome indicators. Result An article will be drafted to reflect a scoping review about surgical managements of metastatic bone disease of the hip. Conclusion The results of this review will go beyond previous studies, and attempt to fully understand the clinical evidence, demonstrating the importance of hip-related surgery in bone metastatic disease, to provide reference evidence for patients, doctors, and policymakers. Registration This protocol was not prospectively registered in any literature review databases, due to their reluctance to accept this kind of review protocol.

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Prosthesis or osteosynthesis for the treatment of a pathological hip fracture? A nationwide registry-based cohort study

Abstract: Highlights Prostheses result in lower pain than osteosyntheses in pathological hip fractures. Surgeons in sarcoma centers generally use prostheses for pathological hip fractures. Both methods use similar healthcare resources and effectively restore ambulation.

Cited by 4 publications

References 22 publications

Team Approach: Management of Pathologic Fractures

Team Approach: Management of Pathologic Fractures

Investigation of the predictive value of systemic immune inflammation index (SII) and prognostic nutritional index (PNI) on mortality in patients with endoprosthesis after hip fracture

Surgical treatments of metastatic bone disease of the hip joint：A scoping review protocol

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